I hit the mental illness trifecta. I have depression, bipolar AND alcoholism. I think of them as my wiley little triplets. If one wants to take a nap, the other two won’t have it. They get so wound up that nap time is a bust. They are very, very strong. They play rough and by their own rules. They do NOT like to be told what to do and will do everything and anything to stop anyone who tries to control them. Alcoholism is the ring-leader.

Controlling them is like squeezing one of those squishy toys filled with liquid. Grab one end and the other end pops out. Grab the middle and the ends pop out. Grab both ends and the middle pops out. Everyday I check the whereabouts of all three. “Depression, how are you feeling today? Want a drink to make you feel better?”

I take medications for the depression and bipolar and see my therapist. The medicine I take for my alcoholism is a 12-step program. That is how serious I take the disease of alcoholism and my program of recovery. It is medicine, just like antidepressants and mood-stabilizers. It’s not something I can slack off on today just because I have managed to stay away from a drink for nearly 11 years. I am always one drink away from relapse and I always will be.

I learned the hard way not to mess with my antidepressants and mood-stabilizer. Last year, I stupidly decided to cut the doses because I felt better. I finally ratted myself out to my nurse practitioner and she chewed me out. I am so grateful that I have not had the same experience with my alcoholism – “You’re feeling so much better and you haven’t craved a drink in years. Go ahead, have just one…”

Game over.

These can be – and often are – fatal illnesses, especially when you have all three. No matter what, no matter what, no matter what – I treat all three – everyday. Right now, all three are in time-out and mom is very, very happy.

So, looks like we have ANOTHER doctor accused of prescribing drugs that killed a celeb. This time it’s Michael Jackson’s doctor. Apparently, Jackson’s doctor injected propofol – a powerful anesthetic- to Jackson the night he died. Tox reports are not in but investigators believe the drug caused his heart to stop. Two years ago it was Anna Nicole Smith and the psychiatrist who prescribed a smorgaasbord of benzos to her in the months before her death.

Obviously, I am NOT a doctor. But I don’t need a medical degree to know that both these celebs has serious mental illnesses. You only had to watch one episode of Anna Nicole Smith’s reality television show to see that she was an addict. One look at Michael Jackson and you could tell he had – at the very least – some body-image issues (Body Dysmorphic Disorder).

Mental illnesses are like potato chips: Many of us have more than one. In the medical world they call it “co-morbidity.” In other words, you have more than one illness going on. Some research shows that at least 30 percent of addicts and alcoholics have at least one companion mental illness. Knowing this, wouldn’t you screen your patient for substance abuse if they came to your office looking like Michael Jackson or Anna Nicole Smith?

Where is the line between common-sense and criminal negligence? These doctors aren’t stupid. I truly believe that Anna Nicole’s doctor knew that Anna Nicole was a addict. Despite that knowledge, the doctor made a conscious decision to prescribe benzos to Ms. Anna Nicole Addict. Same with Michael. What kind of doctor injects Diprivan to help you sleep at night? Maybe to help you sleep DURING SURGERY but not to go nighty-night.

I believe these doctors were seduced by celebrity and money. But what about the doctors treating folks like you and me? Did your doctor screen you for substance abuse before writing you a ‘script for Xanax or Klonopin? Likewise, if you are in treatment for substance abuse, did your doctor screen your for depression and bipolar?

Let’s put it this way: It’s common practice for a doctor treating a diabetic to screen …

I am blessed to have a friend with bipolar. She called me a couple of days ago after reading about how much I liked my mania. She likes her mania, too. Our manic espisodes are filled with paint brushes, staple guns, potting soil, photo albums, shovels, sewing machines, swatches of fabric, endless furniture arrranging and countless trips to Home Depot.

She wanted to remind me of the Bipolar Law of Emotion: For every emotion, there is an equal and opposite emotional commotion. Why do I forget this when I am manic? It’s like the “consequence lobe” of my brain shuts down. Same thing used to happen when I drank. The memory of my last hangover was gone. That horrible, sick feeling of waking up and not being able to remember when or how or with whom I got into bed. How do you forget stuff like that?

So I was very grateful that my friend called. She warned me about romanticizing my mania. She talked about her manic to-do project list. Start something, then start something else, the start another something else and on and on. You end up with half-painted walls and a sewing machine gathering dust on the kitchen table. Then you crash and you find yourself staring at a half-painted wall.

We talked and talked and I realized that I should think of my bipolar as a continuum of emotions, feelings and behaviors instead of compartmentalizing it. I like to think I have manic or depressive “episodes” – like my illness is some kind of TV show. “On tonight’s episode we’ll see how Christine is coming along with that herringbone-patterned brick driveway she is laying!” or “Tonight’s episode is cancelled because Christine has no intention of getting out of bed.”

No, my bipolar is like an Etch-a-Sketch. Twist the nob this way and the line goes up, the other way it goes down or right or left but there is ALWAYS a line. It never breaks. The highs and lows are connected. I need to brand that into my brain. I am working on it.

In the meantime, I had dinner with my friend last night. She …

What is up with Dr. Thomas Szasz?

I know Szasz is the name to drop when I want to rile up a debate about the state of psychiatry in America. As a proponent of the Anti-Psychiatry movement in the 60′s, Szasz ticked off – and continues to tick off – mainstream psychiatry with his belief that mental illness is a metaphor for bad and bizarre behavior and that the pharmaceutical industry and mainstream medical community have perverted treatment for these problems.

But Szasz went way over the top with an article in the Wall Street Journal on July 15. I have a problem Szasz’ comparison of car repairs to health “repairs.” Bizarre.  Big difference between a humane society’s responsibility to pay for my car repairs versus my body “repairs.”

“The concept of reimbursable health-care service rests on the premise that the medical problem in need of servicing is the result of involuntary, unwanted happening, not the result of voluntary, goal-directed behavior. Leukemia, lupus, prostate cancer, and many infectious diseased are unwanted happenings. Are we going to county obesity, smoking, depression and schizophrenia as the same kinds of diseases?”

I don’t know where he gets that idea. I have never categorized medical problems “in need of servicing” under reimbursable health care as either voluntary or involuntary maladies. Carry Szasz’ logic a few steps further and you have to ask – who gets to decide whether a medical problem is voluntary or involuntary? I hope it is not Szasz.

Why wouldn’t we lump depression and schizophrenia in with “involuntary, unwanted happenings” such as leukemia and lupus? It has been nearly 50 years since Szasz began making his argument that mental illness should not be classified as a disease. Maybe back then, before the invention of CAT, PET and other technologies used in neuroimaging, Szasz’ theory kinda made sense.  But come on. In 1961, the year Szasz published his controversial book, The Myth of Mental Illness, IBM introduced the Selectric typewriter. That is how advanced technology was.

How much science do we need before we stop classifying mental illnesses as character defects or bad behavior? And let’s not use the argument that if …

I’m manic. I’m up. I’m tearing it up.

I realized it yesterday while I was in a meeting with one of the paper’s top editors. Ideas came flying out of my mouth. Damn good ideas, I might add. It didn’t help that I was sitting next to a brilliant intern who was so excited to even be in the meeting that he was talking a mile-a-minute. I sucked in all of his hyperactivity and was off.

Then I read an entire GAO report and studied the complex schema of a spreadsheet. Then I wrote a column. Then I ate lunch at my desk. Then I got really riled up about the closing of a public swimming pool (why can’t they close the public golf course instead?) and asked the editor of the editorial page if I could write a column. Thankfully, he said no (although his reason didn’t make any sense). Thankfully, I didn’t argue with him…much.

I just started my day and I can already feel the mania. I am going to the gym to see if I can get rid of some of it. But you know, deep down, I really don’t want to get rid of it. It’s sick, but I really like it. I just don’t like what happens when the mania ends.

I walked on the beach last night with a friend. It was a stunning evening. The stars looked like holes to heaven. The warm foamy water lapped my feet. I followed the tracks of mama loggerhead turtles who had come ashore to lay their eggs  We stopped for ice cream and ran into a couple vacationing here in Palm Beach who went on and on about the beauty here – palm trees, the stunning Mediterranean architecture and the ocean.

I take all this for granted…again. Since my last major depression several years ago I have come to take all of this beauty as a routine part of my life. During my last major depression I came to these beaches in desperate hope of finding some relief. I desperately searched at the shells and sand and water and mansions and palm trees and dune grass and sea gulls and driftwood and clouds for some relief. I went to the beach almost everyday – a gift of disability insurance – and searched for gratitude and serenity. Never was my appreciation for the beauty around me more intense than when I was depressed. I could see it all but it did not move me.

“How can you possibly feel this way in a place like this?” I asked myself over and over. Everyday I walked and talked to God. After weeks of these sad, sad walks I looked around and realized that nothing in the physical world had changed. Everything was fine. The world was not a horrible place. I must really be sick if I can be surrounded by all this tranquility and beauty and feel this much despair. I was not an ungrateful sloth. I was sick. I am sick. This is real. Depression is real.

I began forgiving myself for being sick. Depression is an illness that robs me of the ability to see, feel, taste, feel and hear beauty. When I am sick I am not able to find joy and wonderment in profound beauty. I am not an ingrate. I am not a bad. I am sick.

As I walked on the very same stretch of beach last night …

The reality of impending layoffs has set in. We are now in an agonizing game of musical chairs. We know there are not enough chairs for all of us but we do not know how many will be chair-less. We have been told the music will stop in mid-August. Some must reapply for their own jobs. Some will apply for new ones. It doesn’t matter how many years you have been with the company. Those are the rules.

By the time it is over we will have been trudging and interviewing for 8 weeks. Two months of occupational purgatory. We played a similar game last summer, which lasted about three months. Our summer, the carefree season of vacations, beaches, golf and tennis, is already over.

The office is toxic. The stress is visceral. I had my melt-down a few weeks ago. Waves of anxiety and fear – it’s like being on an emotional roller-coaster, wondering if you are going to hurl. But the last couple of weeks have been good. My therapist and the head of Human Resources offered the same advice: This is a loss. Grieve it.

If there is one thing I know how to do it is grieve a loss. I don’t always do it well, but I know how to do it. Not grieving my losses hurled me into a major depression three years ago. In the space of two years I lost my parents, dog and long-term relationship. I trudged on believing that grieving ended with the last shovel of dirt thrown on a grave.

When I finally climbed up and out my black hole, I practically begged to learn how to grieve. Anger. Sadness. Bargaining. Denial. Acceptance – and not necessarily in that order. And not just once. A few weeks ago I waffled between anger and sadness. Then denial. Back to anger. Then bargaining and more anger. I dabbled in denial but the anger kept taking over. My feelings ping-ponged furiously. I talked to my therapist and some friends. I wrote. I talked. I let myself be sad, angry and oblivious. I wore out the Serenity Prayer.

Today – right now – I …

Sometimes I drink in my dreams. Almost 11 years of sobriety and I still get drunk dreams. I can’t say they are nightmares because, well, if you are a recovering alcoholic these dreams are as close as you will ever come to a drink. Kind of like a freebie! Until I get to the part of the dream where I realize what I have done and what I will have to. Then I wake up sober with more gratitude than you can imagine.

Relapse is among my worst fears. Picking up a drink or drug means going down into my black hole. My alcoholism and depression are conjoined twins. When I dump some alcohol on my depression I might as well put everything I own on the bar. Game over.

Which brings me to Rep. Patrick Kennedy, son of Sen. Ted Kennedy. Patrick is dual-diagnosed. He has struggled for years with his mental illnesses. There is no anonymous in Patrick’s program. A couple of car accidents and controversial lineage has taken care of that. He has been in rehabs. He has relapsed. We know his story.

This time, he did what we are trained to do but often don’t. He listened and took suggestions. Those around him told him he was in relapse mode. So he checked himself into rehab last month BEFORE he picked up a drink or drug. If you are a “normie” – someone who is not an addict or alcoholic – you are probably saying “Duh!” But for us, this is a huge accomplishment. Huge.

A relapse does not always happen suddenly. While a relapse builds we lose our sense of hearing and sight. We do not hear what you are saying or see our own behavior. We need help. That is why recovery is a “We” program. We spot each other – tell each other when we notice relapse behavior: depression; mania; weight loss/gain; anger/rage/resentment; isolating; skipping meetings; and not taking phone calls.

I don’t know who spotted Kennedy’s relapse behavior. I do know that Kennedy has a good friend in retired Rep. Jim Ramstad  - another recovering alcoholic. I met Kennedy and Ramstad earlier …

Sometimes, when I have been feeling really good for awhile, I begin to think that maybe I have made up all this depression and bipolar stuff. Maybe I am faking it or making it a bigger deal than it is.

Those thoughts were rolling around in my noggin recently when I found the blue folder. I had been looking for something – I can’t remember what – and a saw a box on a shelf in my closet. I pulled it down and opened it. There were some photos, my old newspaper clippings, legal papers – the usual stuff you find in boxes on a shelf in the closet. Then I found the blue folder.

I recognized it right away. It held some of my teen writings. I journaled a lot when I was a teen. I found most of my teen journals several years ago. Reading them was so painful that I stopped and gave them to my therapist. I didn’t want them in my house. But I had forgotten about the blue folder.

I’m not whole. I have to do something for myself. I try to tell myself I am not tired. Try to convince myself. It used to work but now it is no use. I need one minute to think. Everything is going so fast…I am always alone yet never. My mind aches to be alone. Not to have anything to think. Wishes never come true. Die.

I was 19 when I wrote that. There is much, much more. I knew I was not a happy, well-adjusted teen. I drank. I took drugs. I wrote horrible poetry. I wanted to die and gave it a couple of lame attempts. I cried when I read what I had written so many decades ago. But I am glad I found these writings. Now I don’t have to wonder whether my depression and bipolar are real. They are real and they have been real for a very, very long time.

God bless astronaut Buzz Aldrin. In his new memoir “Magnificent Isolation: The Long Journey Home from the Moon.” Aldrin – the second human to set foot on the moon – candidly lays out his battle with alcoholism and depression. Yes, that’s right. Buzz Aldrin – as manly as manly gets – is dual diagnosed and he is not ashamed.

“For most of the first several weeks after my depression began I could not be consoled. There were days I could not get out of bed Some mornings I responded to the doctor’s questions, other mornings, I ignored his questions and carried on my litany of self-doubt and self-hate. At times I felt hopelessly snarled in the tangle of my mind.”

Neither is former Pittsburgh Steeler’s quarterback Terry Bradshaw, who won FOUR Super Bowls. I interviewed Bradshaw earlier this year: “”How can I play in the Super Bowl and hate every second of it? The weeks following were even worse than that.”

Eric Clapton went public about this alcoholism. Other mentally ill men include Eminem, Adam Duritz (Counting Crows) and Trent Reznor (Nine Inch Nails). But wait, there’s more: Abraham Lincoln; Billy Joel; Boris Yeltsin; Mike Wallace; Winston Churchill; Drew Carey; Jim Carrey; Harrison Ford; Richard Jeni; Steven Hawking; John Cleese; Marlon Brando; Sting; and Ty Cobb.

Guys, what’s it going to take? Indiana Jones and The Godfather have depression. I I see so many men with depression today. The economy has eviscerated their masculinity. Women turn their depression inward. Men turn it outward: Anger; rage; sarcasm; physical abuse; drinking; drugging; sexual escapades.

Guys, it’s okay. How much more manly can you get than Terry Bradshaw, Ty Cobb and Buzz Aldrin? I have written about men and depression before but it is getting worse. You cannot control what it happening at work so you put a choke hold everyone and everything else in your life. Friends and neighbors tell me how the men in their lives are self-destructing.  They tell me the horrible things you say that you cannot possibly mean.

We want to help you. Buzz Aldrin and Terry Bradshaw want to help you. What other men do you need to hear from to convince …